Atlantoaxial Stabilization Using C1 and C2 Laminar Screw Fixation

Area of Science:

• Neurosurgery
• Orthopedic Surgery
• Spinal Surgery

Background:

• Cervical spine fractures can lead to complex vascular anomalies, including persistent first intersegmental artery and vertebral artery occlusion.
• Surgical management of atlantoaxial instability in the presence of anomalous vertebral arteries presents significant challenges due to the risk of iatrogenic injury.

Purpose of the Study:

• To describe a salvage surgical technique utilizing combined C1 and C2 laminar screws for treating patients with specific cervical spine injuries and vertebral artery anomalies.
• To evaluate the efficacy and safety of this technique in achieving stable fixation while minimizing vertebral artery injury.

Main Methods:

• A case series describing the application of C1 and C2 laminar screws as a salvage procedure in two patients.
• Focus on the surgical technique for fixation of the atlantoaxial joint in the context of anomalous vertebral arteries.

Main Results:

• Successful fixation of the atlantoaxial joint was achieved in both patients using the combined C1 and C2 laminar screw technique.
• The technique demonstrated a low risk of vertebral artery injury, preserving vascular integrity.

Conclusions:

• The combined use of C1 and C2 laminar screws is a viable alternative surgical option for managing atlantoaxial instability.
• This technique is particularly beneficial for patients with congenital or traumatic vertebral artery anomalies, offering secure fixation with reduced vascular complication risk.